University of Pittsburgh Medical Center St. Margaret Family Medicine Residency Program, Pittsburgh, Pennsylvania.
Am Fam Physician. 2023 Jan;107(1):26-34.
Individuals with skin of color represent a diverse population of racial and ethnic backgrounds, including but not limited to Black or African American, American Indian or Alaska Native, Asian American or Pacific Islander, Hispanic or Latino, and Middle Eastern or North African. Dermatologic health disparities exist in part because of systemic racism and are exacerbated by inadequate physician training and a lack of high-quality research on skin diagnoses that disproportionately affect people with skin of color. These conditions, which include postinflammatory hyperpigmentation, keloids, dermatosis papulosa nigra, pseudofolliculitis barbae, and acne keloidalis nuchae, are usually diagnosed clinically and not associated with an underlying systemic disease. They can have significant impacts on mental health and quality of life and are often underdiagnosed or undertreated in skin of color. Hydroquinone 4% is considered the standard treatment for postinflammatory hyperpigmentation. Standard treatment for keloids includes combination intralesional therapy with triamcinolone and fluorouracil. If treatment is preferred for dermatosis papulosa nigra, options include scissor excision, cryotherapy, curettage, electrodesiccation, and laser therapies. Shaving cessation is the best initial treatment for pseudofolliculitis barbae. Individuals with acne keloidalis nuchae should avoid frequent close shaves or short haircuts on the nuchal area of the scalp.
有色人种个体代表了具有不同种族和族裔背景的多样化人群,包括但不限于非裔美国人、美洲原住民、亚裔美国人或太平洋岛民、西班牙裔或拉丁裔以及中东或北非地区的人。皮肤健康方面的差异部分是由于系统性种族主义造成的,而医生培训不足和缺乏高质量的皮肤诊断研究进一步加剧了这种情况,这些研究对皮肤颜色较深的人影响更大。这些病症包括炎症后色素沉着过度、瘢痕疙瘩、黑棘皮病、假性须部毛囊炎和瘢痕性脱发,通常通过临床诊断,与潜在的系统性疾病无关。这些病症对心理健康和生活质量有重大影响,在皮肤颜色较深的人中常常被漏诊或治疗不足。4%氢醌被认为是炎症后色素沉着过度的标准治疗方法。瘢痕疙瘩的标准治疗包括曲安奈德和氟尿嘧啶联合病灶内治疗。如果选择治疗黑棘皮病,可选择的方法包括剪刀切除、冷冻疗法、刮除术、电干燥法和激光治疗。停止剃毛是假性须部毛囊炎的最佳初始治疗方法。患有瘢痕性脱发的人应避免在头皮颈后部频繁进行紧贴皮肤的刮剃或短发修剪。